전방십자인대 재건술시 경골 터널 길이의 계산법

Abstract

When performing an anterior cruciate ligament(ACL) reconstruction using a two-incision technique, graft length from the lateral femoral cortex to the anterior tibial cortex is usually of no concern, and bitunnel interference screw fixation can be achieved. But in the endoscopic one-incision technique, placing the graft's tendon-bone interface flush with the intraarticular femoral tunnel results in distal graft protrusion. Mismatch can be avoided if the sum of the tibial tunnel length plus the intraarticular distance of ACL is equal to or greater than the graft tendon length plus 20 mm (the minimum interference fixation possible when using the smallest available 20 mm long interference screw). The purpose of this study is to detennine the relationship between the length of patellar tendon and that of anterior cruciate ligament, to calculate the tibial tunnel depth with this for the elincination of graft-tunnel mismatch through the dissection of 19 cadaveric knees. The results were as follows: 1. The average patellar tendon length was 36.2+4.7mrn (range 24.7-45.0). 2. The average ACL. Length was 23.7+3.9mn (range 16.5-30.3). 3. ACL length(mm) = 0.73 >< Patellar tendon length - 2.69 (p<0.001) 4. Tibiaf tunnel depth(mm) = 0.27 X Patellar tendon length + 27.69 Although it shoud be verified with the clinical results, it can be concluded that the graft-tunnel mismatch can he dininished if the tibial tunnel depth is calculated before inserting a guide wire for tibial tunnel with this formula in the endoscopic one-incision ACL reconstruction.